WJM

World Journal of Microbiology

Vol. 3(1), pp. 061-063, October, 2016. www.premierpublishers.org, ISSN: 2141-5032x

Research Article

Occurrence
and
antibiotic
susceptibility
of
Streptococcus pyogenes isolated from throat of
patients that attended federal medical centre Umuahia,
Abia state
Nwankwo I. U1*, Ifediora A.C2. Onwuakor C.E3, Adonu N. C4
1*,2,3,4

Department of Microbiology ,College of Natural Sciences, Michael Okpara University of Agriculture Umudike, Abia
State, Nigeria.
A total of 24 throat samples were collected from Patients in Federal Medical Centre Umuahia,
Abia State, to evaluate the prevalence of S. pyogenes and its antibiotic sensitivity. 17(70.8%)
samples yielded Streptococcus pyogenes which was identified following some identification
test. The incident rate was higher among those within the age of 5-25 years (53%). 58% of the
isolate were from females. S. pyogenens showed 100% sensitivity to levofloxacin, vancomycin,
penicillin G and amoxicillin and was resistant to tetracycline (58.8%). Penicillin, amoxicillin,
levofloxacin and vancomycin could serve at first line drug of choice for the treatment of S.
pyogenes infection.
Key words: Occurrence, resistance, Streptococcus pyogenes, Umuahia

INTRODUCTION
Streptococcus pyogenes is estimated to be present in 515% of normal individual in the respiratory track, skin and
anus without any sign of disease. The pathogenesis of
Streptococcus pyogenes is mediated by a variety of
factors, one of them is streptolysin O toxin which
damage cell membrane and account for the haemolysis
demonstrated on sheep blood agar (Ozturk et al., 2004)
Disease spectrum of Streptococcus pyogenes ranges
from mild infection as pharyngitis, tonsilities and impetigo
to life threatening infection like necrotizing fascititis and
toxic shock-like syndrome. These are often followed by
post infective sequelae of rheumatic fever, rheumatic
heart
disease
and
post
streptococcal
acute
glomerulonephritis (Capoor et al; 2006). Severe forms of
this disease have been detected in various part of the
world (Stevens et al; 1994).
Streptococcus pyogenes infection is ordinarily spread by
direct person-to-person contact most likely via drops of
saliva, nasal secretion, contaminated fingers, dust or
formites (Arguelles et al; 2004).

Streptococcus pyogenes is one of the most virulent

species of Streptococcus causing human infections
(Euzeby et al., 2012). S. pyogenes is a prototype
bacterium that causes exotoxins-mediated infections, it
produces a plethora of exotoxins, super-antigens and cell
wall associated proteins resulting in diverse clinical
manifestations, ranging from classical pyogenic infections
to toxic shock syndrome and post-infection immune
mediated sequelae. Streptococal pyoderma and
pharyngotonsillitis remain common infection with a heavy
global burden of disease (Carapetis et al; 2005).

*Correspondence author: Nwankwo I.U., Department of

Microbiology ,College of Natural Sciences, Michael
Okpara University of Agriculture Umudike, Abia State,
Nigeria.
Email:
immaugo@yahoo.com,
afoma20@yahoo.com

Occurrence and antibiotic susceptibility of Streptococcus pyogenes isolated from throat of patients that attended federal medical centre Umuahia, Abia state

Nwankwo et al.

062

S. pyogenes is considered to be a human-adapted

pathogen. S. pyogenes is the Streptococcal species most
commonly associated with epidemic and outbreaks are
characterized by the diversity of clinical syndromes and
occurrence in both the community (such as within
families, schools, day care center and prisons) and health
care institutions. However, during the latest 2009
pandemic influenza, S. pyogenes has re-emerged as a
cause of bacterial super infection.
All Group A streptococcus are sensitive to penicillin G,
and most are sensitive to erythromycin.
A high frequency of resistance to erythromycin in
Streptococcus pyogenes has been reported particularly in
countries where antibiotics are over used. In Nigeria
there is no existing control program for Streptococci,
more over such programs are not in the row. The
increase in the incidence of strains that are resistant to
current antibacterial agents highlights the need to assess
the occurrence and resistance of this pathogen to
antibiotics.

MATERIALS AND METHODS

Sample Collection
Throat swabs of 24 patients within the age of 5-67 years
were collected using sterile throat swab sticks. The swab
sticks were rubbed with rotation over tonsilar area, then
the arch of area and finally the posterior pharyngeal wall.
Each sample was labeled with various information
including age and sex. The samples were transported to
the laboratory in sterile condition within 1-2 hours for
processing.
Sample Processing
The sample swab was rubbed by rotating over a large
area about one third of the surface on a blood agar plate
and was streaked out with a loop over the remaining part
0
of the plate and incubated at 37 C for 24 hours.
Streptococcus pyogenes produced beta-hemolytic
colonies (that is the colonies were surrounded by zone of
complete
haemolysis
with
decolorization
of
haemoglobin). The suspected colony was taken out from
primary culture on blood plates and subcultured on
crystal violet blood agar(CVBA) plate by placing a
bacitracin disc (0.05 units) over initial streaked area and
cotrimoxazole disc in secondary streaked area and
0
incubated at 37 C for 24 hours. A haemolytic colonies
slowing bacitracin sensitive and cotrimoxazole resistivity
on CVBA was further identified by Gram staining,
catalase test and Pyrrolidonyl Arylamisase (PYR) test.
Antibiotic Susceptibility Test
All

the identified Group A streptococci isolate (S.

pyogenes) from throat were subjected to in-vitro

susceptibility test my modified Kirby-bauer disc diffusion
method. The antibiotic used in the study were;
Teracycline (30g), Erythromycin (15g), Cephalexin
(30g), Penicillin G. (10g), Gentamycin (10g),
Ciprofloxacin (10g), Amoxicillin (30g), Levofloxacin
(20g), Chlorophenicol (10g) and Vancomycin (10g).
Mueller-Hinton agar plates were inoculated with the
isolates antibiotics discs were placed on the medium and
0
plates were incubated at 37 C for 18-24 hours and results
were obtained by measuring the diameter of the zones of
inhibition.

RESULTS
Among 24 patients, 11 (45.8%) were males and 13
(54.2%) were females. Out of 24 throat swabs studied, S.
pyogenes was isolated from 17 samples (70.8%).
7(41.2%)of then isolates were from males whereas
10(58.8%) were from females. Highest colonization of S.
pyogenes was found in the age group. 5-25 years,
followed by 47-67years and lowest among age group 2646 years (Table 2).
S. pyogenes isolates showed a relative high rate of
resistance towards tetracycline (58.8%) followed by
Erythromycin (17.7%). The isolates showed 100%
sensitivity to levofloxacin, vancomycin, penicillin G and
amoxicillin (Table 3).

DISCUSSION
Group A beta-hemolytic streptococci (GABAS) is among
the most prevalent bacterial infection and constitute 60%80% of all cases of exudates pharyngitis (Rijal et al.,
2009).Out of 24 samples, age groups ranging from 5-67
years, S. pyogenes was isolated from 17 samples (Table
1) 10 (58.8%) were females and 7 (41.2%) from males.
High occurrence of S. pyogenes in females than males
could be as a result of influence of female hormones on
adherence ability of Streptococcus pyogenes strains to
the host cell. However it is in disagreement with the
results obtained in turkey as reported by Durmaz et al.,
(2003). In relation to age, the condition was most
prevalent in the age between 5-25 years, the highest
prevalence occurring in 7 years old children
(schoolchildren) as a result of the close proximity of a
large number of susceptible children in a relatively
contained environment; such as classrooms and
churches, as the disease spread through person to
person contact, through nasal droplets, secretions or
saliva and spread when those secretions come in contact
with the mouth, nose, eye, scrap and wound. The
condition was also seen to be high in age group 4767due to the fact that most of them are immunecompromised patients with diabetes mellitus. This is in

Occurrence and antibiotic susceptibility of Streptococcus pyogenes isolated from throat of patients that attended federal medical centre Umuahia, Abia state

World J. Microbiol.

agreement with the study carried out in Pokhara as

reported by Rijal et al., (2003). None of the 17 isolates
was resistant to penicillin, vancomycin, amoxicillicn and
levofloxacin, while slight resistance of S. pyogenes was
observed with ciprofloxacin, gentamycin, chloromphenicol
and cephalexin; this corresponds with the results
obtained in USA with 21% resistance as reported by
Guege et al., (2009). S. pyogenes showed almost
completely resistant to tetracycline and erythromycin. The
resistance could be due to the presence of mef (A), tet
(O), tet(M) and erm (A) genes in S. pyogenes. Giovanetti
et al., (2004)

CONCLUSION
Acute respiratory tract infections despite antimicrobial
therapies remain frequent and a real health problem. S.
pyogenes show great variability overtime in incidence
and clinical presentation. Infections with S. pyogenes are
currently among the main cause of mortality in
developing countries. The diversity and severity of its
clinical spectrum should encourage clinicians and
microbiologist to pay more attention, it is important to
always identify and explore susceptibility of these
pathogens to antibiotics in order to contribute to the
improvement of care. Result obtained shows that all
strains of S. pyogenes were sensitive to penicillin,
amoxicillin, levofloxacin and vancomycin thus remain the
first choice for the treatment of S. pyogenes infection.

063

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Accepted 25 June, 2016.
Citation: Nwankwo IU, Ifediora AC, Onwuakor CE, Adonu
NC (2016). Occurrence and antibiotic susceptibility of
Streptococcus pyogenes isolated from throat of patients
that attended federal medical centre Umuahia, Abia state.
World Journal of Microbiology, 3(1): 061-063.

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Copyright: 2016 Nwankwo et al. This is an openaccess article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are cited.

Occurrence and antibiotic susceptibility of Streptococcus pyogenes isolated from throat of patients that attended federal medical centre Umuahia, Abia state